DEMS POINTING FINGERS AT CONTRACTORS OVER EXCHANGE PROBLEMS — Democrat-led states that clamored to build their own exchanges are now blaming the contractors they hired for high-profile failures. POLITICO’s Anna Palmer and Pro’s Jennifer Haberkorn report: “Facing an onslaught of constituent frustration over problems with online exchanges, several Democrats have started pointing fingers at the companies and senior executives in their home states that have contracts to get the health care websites up and running.” Dems in Oregon Massachusetts, Minnesota and Vermont have lashed out at the contractors they hired. http://politi.co/1aJNjvW

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MARK YOUR CALENDARS — The Supreme Court will hear oral arguments March 25 in the two cases in which businesses are challenging the Obama administration’s contraception coverage requirement, the court announced Wednesday.

SURVEY: ONE IN FOUR POTENTIALLY ELIGIBLE ADULTS HAVE VISITED EXCHANGE — One in four Americans potentially eligible for new coverage had visited health insurance exchanges as of December, the Commonwealth Fund found in a survey conducted from Dec. 11 through Dec. 29. Two in five of the exchange visitors were between the ages of 19 to 34 and three-quarters described themselves as being in good, very good or excellent health. The survey found that people using the site in December reported a vastly improved experience over October, but 70 percent rated their experience with the marketplace as “fair” or “poor.” About a fifth of visitors had received cancelation notices from their insurer. The survey of 622 adults carries a 4.56 percentage point margin of error.

Happy Thursday and welcome to PULSE, where our limited fashion sense was nevertheless on red alert this week. A company called Tutem is pitching its “sick chic” line of personal masks to help prevent the spread of germs through coughing, sneezing and all-around wintertime grossness. Your PULSEr may have a case of the sniffles, but a mask with butterfly prints is not in our wardrobe: http://bit.ly/1dY4UEX

“Like a PULSE over troubled water, I will lay me down”

UNIONS SEEKING LENGTHIER EXEMPTION FROM OBAMACARE FEE — Unions pressed the Obama administration for a lengthier exemption from an Obamacare fee even though they’re not sure how many of their members it would affect. Pro’s Jason Millman reports: “In November, HHS proposed exempting some groups from paying into a three-year Obamacare program offering insurers financial protection if a large share of sick customers sign up for individual coverage … The debate underscores general tensions between the Obama administration and unions regarding President Barack Obama’s health law. Unions were disappointed last year when the administration decided it couldn’t provide federal subsidies for union health plans.” http://politico.pro/1giApZT

ANTI-OBAMACARE VOTES COMING – Well, that didn’t take long. The House teed up a slate of anti-Obamacare legislation this week and is showing no signs up letting up. It’s a different approach than either of the last two years when Republicans were awaiting a Supreme Court ruling on the law and smarting from President Barack Obama’s reelection. “Now that January 2014 is here, Obamacare has become a reality for all Americans and their families,” House Majority Leader Eric Cantor said Wednesday. “The House this week is going to be approaching that issue in a very deliberate and appropriate manner.” http://politi.co/JK0W7K

--Rep. Pete Sessions (R-Texas) may have been joking when he hinted that the House wasn’t going to be pursuing full repeal anymore, but Democrats jumped on his comments to suggest the GOP leadership was changing its tune. POLITICO’s Ginger Gibson reports: “The statement from Sessions appears to run counter to other House leadership remarks, including a policy memo House Majority Leader Eric Cantor sent to members last week.” http://politi.co/KFQD5A

** A message from the American Cancer Society Cancer Action Network: When tobacco prices go up, tobacco use goes down. Congress has a real opportunity to save nearly 1 million lives and reduce health care spending by $63 billion just by increasing the tobacco tax. Support S.826 to increase the tobacco tax and save lives. Learn more at acscan.org.

ISSA RIPS SEBELIUS TESTIMONY AS “FALSE AND MISLEADING” — House Oversight Chairman Darrell Issa continued his intense push to highlight security risks of HealthCare.gov, accusing HHS Secretary Kathleen Sebelius of giving “false and misleading” testimony to Congress. In a letter to Sebelius today, he accused the secretary of making false statements on several points, based on what he characterized as contradictory testimony by the agency’s security testing contractors and CMS’s chief information security officer, Theresa Fryer. In a statement, HHS said the agency would respond to the letter and reiterated — as officials have in prior testimony — that all the elements of HealthCare.gov that are live comply with Federal Information Security Management Act standards.

--A substantial part of the complaint in Issa's letter stems from a Sept. 24 draft memo by Fryer recommending that the launch be delayed because of potential security vulnerabilities. In December, Issa released a partial transcript of an interview with Fryer suggesting that the site had been launched over her objection. But — as Oversight Dems were quick to point out — her draft memo was never seen by the agency leadership because it was never sent. Fryer did not oppose the launch. The minority's response to Issa's claims about Fryer: http://1.usa.gov/1hr29wl

TAKING STOCK OF TOBACCO CONTROL EFFORTS — Fifty years after a Surgeon General’s report opened up a new front in efforts to combat tobacco use, public health advocates see mixed results: the adult smoking rate has been cut by more than half since but tobacco use remains the number one cause of preventable deaths in the United States. Pro’s Natalie Villacorta reports: “Nearly 1 in 5 high school students smokes, 20 states have yet to pass laws banning indoor smoking in workplaces, restaurants and bars, and virtually no states are using the billions of dollars collected through a massive tobacco settlement to increase tobacco-cessation programs.” http://politico.pro/1dY4dvv

REPORT: MEDICARE CONTRACTORS FALLING SHORT OF STANDARDS – MACs, the contractors tapped by Medicare to oversee the integrity and functionality of the program, failed to meet a quarter of all performance standards over a three-year period reviewed by the HHS inspector general. According to the IG report, a quarter of those unmet standards remained unresolved 10 months after the initial review. The IG reviewed the performance of 13 MACs from Sept. 2008 to August 2011 and found that missed standards ranged from 13 percent to 48 percent, and at least two fell short in all areas of the review: from claims processing to enrollment to appeals to financial management. “Given the billions of dollars awarded to MACs and the critical role they play in administering the Medicare program, effective oversight of these contractors by CMS is important to ensure that they are carrying out their assigned tasks. In agency comments accompanying the report, CMS said it either had already implemented fixes or was considering the IG’s recommendations. http://politico.pro/1a9YHS6

PENNSYLVANIA DEMOCRATS RIP CORBETT EXPANSION PLAN — Republican Gov. Tom Corbett’s proposal to expand Medicaid using private coverage hasn’t won many fans on the other side of the aisle. Democrats spent Wednesday panning the proposal, arguing that the restrictions that accompany it seem intentionally complicated and unlikely to pass a federal review. One Democratic state senator, Vincent Hughes, sent a letter to the Obama administration urging HHS to reject Corbett’s proposal. And Democrats in the state House convened a hearing with sympathetic panelists who urged Corbett to expand traditional Medicaid without strings attached. Corbett’s plan would mirror Arkansas’s reliance on private health plans, but it would also include work requirements that critics say are unacceptable in a safety-net program.

REPORT: STATES SHOULD EXPERIMENT WITH COST CONTROL STRATEGIES — States are laboratories for health care cost control and should take aggressive steps to experiment with new strategies, according to a new report from a commission created by the Miller Center and the University of Virginia. With huge Medicaid programs and state employee workforces, states have opportunities to test new ideas that encourage high-quality, efficient care, the commission contended. They also should focus on more end-of-life care, according to the report.

WHAT WE’RE READING, by Brett Norman:

Americans may be bored with Obamacare post- HealthCare.gov crisis, and that may be the best news the law could get, Sarah Kliff reports at the Washington Post. http://wapo.st/K7zgtl

Reuters rounds up the latest deadline extensions that insurers are giving to consumers for their January Obamacare premiums. http://reut.rs/1iiQoZu

The RNC got a bunch of free media out of its anti-Obamacare ads targeting vulnerable Dems, but put just a token amount of money behind the buy, Chris Cillizza reports at the Washington Post. http://wapo.st/1ihL7kI

Congressional Republicans deserve public contempt if their only plan for 2014, in the face of significant national problems, is to bet on the failure of the health care law, Norm Ornstein writes in the National Journal. http://bit.ly/1aIZqtg

At California Healthline, Dan Diamond reports on why two small health plans are faring well on Covered California, when most small insurers there are struggling. http://bit.ly/1lRPSl1

The San Diego Tribune’s CEO said the paper was cutting 401K matches because of added Obamacare costs, but the paper is also owned by a major Republican Party contributor and often editorializes against the law, CBS MoneyWatch reports. http://cbsn.ws/1d14Fc3

** A message from the American Cancer Society Cancer Action Network: The more cigarettes cost, the less kids smoke. With 3,500 youth trying their first cigarette every day — more than two per minute — we’re still not doing enough to protect our children from the dangers of smoking. But, higher tobacco taxes are scientifically proven to reduce smoking rates. A 94 cent increase per pack would save nearly 1 million lives and reduce health care spending by $63 billion. Let’s do something to protect our nation’s children. Support S.826 to increase the tobacco tax and save lives. Learn more at acscan.org.

** A message from PhRMA: Diabetes is a complex disease affecting more than 30 million Americans – with one-in-ten living in DC, Maryland and Virginia having the disease. Thanks to advances in diabetes care, patients around the country are living longer, healthier lives. Take five-year-old Rhys for example [link to his I’m Not Average profile]. He was diagnosed with type 1 diabetes at 15-months-old, but today, he is a thriving young boy. This is due in large part to new and innovative medicines developed by researchers and scientists at America’s biopharmaceutical companies. Learn more about the medicines in development for diabetes here. **

Authors:

About The Author

Kyle Cheney is a reporter for POLITICO’s Campaign Pro.

Cheney came to POLITICO in June 2012 to cover health care and spent two years covering the implementation of the Affordable Care Act and its political implications – from the Supreme Court decision upholding the law to the rollout of HealthCare.gov and the coverage gains that ensued. He came to POLITICO after five years reporting on Massachusetts government and politics for the State House News Service, an independent wire service. Coverage, which appeared daily in The Boston Globe, Boston Herald and others, included the implementation of a near-universal health care law; the indictment, trial and conviction of the state’s third felonious House speaker in a row; the rise and reelection of Gov. Deval Patrick; and all matters of public policy.

Cheney, a New York native and unabashed Yankees fan, graduated from Boston University in 2007 with a journalism degree after a semester as editor of BU’s student paper, The Daily Free Press.